2010 Saint - Paul, MN Metro Adult Health Survey for Ramsey County

2010 Saint - Paul, MN Metro Adult Health Survey for Ramsey County

IN THIS TALK

• What is SHIP?

• What is MAHS?

• Results from the survey

1. General Health

2. Infrastructure & Environment

3. Health provider – patient interaction

4. Health behaviors

• Recommendations

• Next steps

WHAT IS THE STATEWIDE HEALTH IMPROVEMENT PROGRAM (SHIP)?

• Part of Minnesota’s health care reform initiative that was signed into law in May 2008

• In 2009, Saint Paul - Ramsey County Public Health received a two-year SHIP grant from the Minnesota Department of Health to create opportunities for healthier choices through policy, systems and environmental change to:

Encourage healthy eating

Encourage physical activity

Reduce tobacco use & exposure

PURPOSE OF THE METRO ADULT HEALTH SURVEY (MAHS)

1. Identify opportunities for new and on-going initiatives to support health in Ramsey County.

2. Provide evidence to support policy recommendations and positive environmental and system changes to enable physical activity and healthy eating and to reduce tobacco use and exposure.

3. Increase public awareness of ways communities, organizations and employers can be involved in supporting healthy lifestyles of adults.

MAHS – DOMAINS AND TOPICS

Six county* survey on :

• General health & chronic disease

conditions

• Eating habits

• Physical activity

• Tobacco Use

• Neighborhood and Community perceptions

• Provider health behavior counseling

*Ramsey, Dakota, Washington, Anoka, Carver, Scott

METHODOLOGY

• Use of addresses through random sample of households

• Response to survey either through mail or telephone

• “Most recent birthday” method used to select one adult respondent within each selected household

• 144 questions asked

• Total respondents: 3150 adult residents of six counties

SURVEY RESPONDENTS Weighted %Categories Ramsey County All counties

Gender Male 47.1 48.6Female 52.9 51.4

Age categories 18-24 13.8 12.025-34 20.4 18.735-44 15.6 19.445-54 18.3 21.555-64 14.5 14.665-74 8.20 7.4075+ 9.20 6.40

Education High school graduate or less 17.9 19.8Some college 33.0 33.6Bachelor's degree 28.0 29.4Graduate or professional degree 21.2 17.3

Poverty status200% below federal poverty line (FPL) 30.0 23.2Greater than 200% FPL 70.0 76.8

Home location An urban area 43.6 16.6A suburb 47.0 63.7A town 8.50 12.2

A rural area 0.90 7.40TOTAL 538 3150

RESULTS

RESULTS DIVIDED IN TO 4 SECTIONS..

1. Health Status


3. Health provider - patient interaction

4. Health behaviors


1. Health Status


3. Health provider - patient interaction 4. Health behaviors

HEALTH STATUS – METRO AREA (6 COUNTIES)

Excellent Very good Good Fair Poor0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

21.1%

41.8%

27.7%

7.6%1.9%

% s

elf

repo

rted

9.5 %

PERCENT REPORTING FAIR/POOR HEALTH BY COUNTY

21%

20%

12%

18%

12%

17% Ramsey

Anoka

Carver

Dakota

Scott

Washington

PERCENT REPORTING FAIR/POOR HEALTH BY GENDER AND AGE (RAMSEY COUNTY)

Gender Age

Male Female 18-34 35-44 45-54 55-64 65-74 75+0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

High school graduate/GED

or less

Some college Bachelor's degree

Graduate or professional

degree

200% poverty or less

Greater than 200% poverty

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

PERCENT REPORTING FAIR/POOR HEALTH BY EDUCATION AND HOUSEHOLD INCOME (RAMSEY COUNTY)

aEducational attainment Poverty status

Anoka Washington Ramsey Scott Dakota Carver50.0%

52.0%

54.0%

56.0%

58.0%

60.0%

62.0%

64.0%

66.0%

68.0%

CALCULATED BMI (OVERWEIGHT/OBESE) BY COUNTY

PERCEPTIONS OF WEIGHT FOR RAMSEY COUNTY

Average for all counties= 41.4%

About the right weight

BMI overweight BMI obese0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

RamseyAll counties

25 – 29.9 > 30

% s

elf

repo

rted

PERCEPTIONS OF WEIGHT FOR RAMSEY COUNTY

Average for all counties= 41.4%

About the right weight

BMI overweight BMI obese0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

RamseyAll counties

Ramsey county : 36% All counties: 39%

% s

elf

repo

rted


1. Health Status



Infrastructure for Healthy Food choices

Physical Activity Community Resources

Reducing Tobacco use and exposure

Smoke freeair

INFRASTRUCTURE & ENVIRONMENT FOR..

Smoke freeairPhysical Activity

Community Resources


Healthy Food choices


Cost

Of those that indicated availability of fruits and vegetables one-half mile from home (55%), 92% High quality88% Large selection was available43% Too expensive

Location

50% Fast food place within 1 mile of their home

36% Had a large supermarket within 1 mile from their home

22% Had a farmer’s market or place to pick up CSA that was less than 1 miles from their home

62% Get food from large supermarkets at least 1 time/week

ACCESS & BARRIERS TO HEALTHY FOOD CHOICES

PLACES FOR PURCHASE OF FOOD

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%Never or less than 1 time per month

PLACES FOR PURCHASE OF FOOD DURING THE GROWING SEASON

Local farm or CSA Food grown at home or in a community garden

Farmer's market or fruit/ vegetable stand

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Never or less than 1 time per month

About 2-3 times per month

2 + times per week

Infrastructure for

Smoke freeair





AVAILABILITY & USE OF COMMUNITY RESOURCES FOR EXERCISE

My community has this and I do not use it My community has this and I use it

Walking trails Parks or sports fields

Bicycle paths Shopping mall Health club Public recreation centers

Public swimming pools

Schools, colleges0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

AWARENESS OF COMMUNITY RESOURCES FOR EXERCISE

Schools, colleges Public swimming pools

Public recreation centers

Walking trails Bicycle paths Health club Shopping mall Parks or sports fields

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

50.0%

I don’t know if my community has this

Infrastructure for

Smoke freeair





PERCEPTIONS OF BARRIERS TO SMOKE FREE AIR

• Around 48% indicated that they had been near someone, in Minnesota, who was smoking in the past 7 days, not including home, workplace or car.

o Sidewalks, building entrances, & restaurants/bars were the most common places that someone was seen smoking.

• Among renters(16%), more than half indicated that people in their building smoke in apartments, patios & balconies

• 16% have been in a vehicle with someone who was smoking in the past week; 26% of those have a college degree


1. Health Status



SELF REPORT VISIT

78.2% had seen a doctor, nurse or other health professional about their health during the past 12 months

HEALTH BEHAVIOR COUNSELING

Among the 78% who visited a health professional,

• 56% were asked about their weight

• 56% were asked about their diet or nutrition

• 56% were asked about smoking or tobacco use

• 67 % were asked about their physical activity


1. Health Status



• 38% ate > 5 servings of fruits and vegetables on day prior to the survey

• 75% ate > 3 servings of fruits and vegetables on day prior to the survey

• 60% eat breakfast everyday in an average week

• 50% did not consume milk the day prior to the survey

• 75% did not consume pop/soda prior to the survey

• 50% ate a meal with their family for > 5 days in an average week

• 76% ate a home cooked meal > 5 times in an average week; while 11% ate at a fast food place at least 3 times per week

FOOD CONSUMPTION

PHYSICAL ACTIVITY

74%

18%

8%

CDC recommendations of 150 minutes or more of moderate or vigorous physical activity per week

Meets recommendations

Insufficient activity

No physical activity

• 87 % reported participating in any form of physical activity or exercise in the past 30 days

• Usual place for exercise• 70% - outdoors (parks, trails)• 68% - at home • 27% - at a health club

• 10% - public recreation facility or community center

• 47% have over 3 hours of TV and computer time per day (while not at work or school); 55 % of these are high school graduates or less

• 67 % reported having sedentary jobs

PHYSICAL ACTIVITY

• Cost of fitness programs, gym memberships or admission fees (24.2%)

• Lack of time (19.8%)• Lack of self-discipline or willpower (17.0%)• Long-term illness, injury or disability (10.3%)• Don’t like to exercise (9.1%)• Lack of athletic ability (8.1%)• Public facilities are not open or available at the times

I want to use them (8.3%)

TOPS ISSUES CONSIDERED “BIG PROBLEMS” IN PREVENTING PHYSICAL ACTIVITY

16%

26%58%

Self reported smoking status

Current smoker

Former smoker

Never smoked

SMOKING STATUS

16% are current smokers 16.3% - Minnesota, BRFSS 2009

TOBACCO USE

• 27% of those below 200% FPL are current smokers

• 24% of18-34 yr olds are current smokers

• Among current smokers, half smoke a half pack or more per day

Quit with

out help fr

om any of t

hese.

Nicotine re

placement p

roduct

Prescr

iption medica

tion

Telephone help line

Some other p

rogra

m

Face

-to-fa

ce co

unselin

g

quit-sm

oking cl

inic

On-line co

unselin

g servi

ce0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

RESOURCES TO QUIT SMOKING

• 14% report having used another tobacco product (such as cigars, pipes, snuff, chewing tobacco, bidis)

• 31.7% of 18-24 yr olds • 20.2% of males vs. 8% of females

• 88% indicated that smoking is NOT ALLOWED anywhere inside the house

• 76% indicated that smoking is NEVER allowed any vehicle

OTHER TOBACCO ISSUES

SUMMARY OF RESULTS FOR RAMSEY COUNTY

Good health is not shared equally across populations in Ramsey county. Disparities in health status exist across gender, different educational attainment , income levels and age groups.

HEALTH BEHAVIORS

• About 30% have been told that they have high blood cholesterol or high blood pressure

• 61% are considered overweight or obese according to BMI

• 36% of those who considered themselves as ‘about the right weight’ are obese or overweight by BMI

• 75% ate > 3 servings of fruits or vegetables on the day prior to the survey

• 74% met CDC physical activity recommendations of 150 minutes or more of mod or vigorous activity per week

• 16% are current smokers

ENVIRONMENT & SYSTEMS (FOOD CHOICES)

• 43% indicated that although fresh fruits and vegetables were available in their neighborhood, they were too expensive

• Only 22% had a farmer’s market or place to pick up CSA that was less than 1 miles from their home

• 96% never purchased food / purchased food less than 1 time per month from a food shelf or pantry

• Food grown at home/community garden was the most common place for purchase of fresh fruits and vegetables in the growing season

• More than 50% reported using walking trails or parks as places for exercising

• Only 27% indicated using health clubs even though they were available in the community

• Less than 30 % used public recreation centers, swimming pools or schools and colleges for physical activity.

• 25% did not know if there existed school or colleges for exercising in the neighborhood, followed by public recreation centers (15%)

ENVIRONMENT & SYSTEMS (PHYSICAL ACTIVITY)

• Around 48% indicated that they had been near someone, in Minnesota, who was smoking in the past 7 days, not including home, workplace or car.

o Sidewalks, building entrances, & restaurants/bars were the most common places that someone was seen smoking.

• More than half of those that rented apartments in multi-unit housing buildings indicated that people in their building smoke in apartments

• Around 67% indicated that they did not seek help from professional sources to help them quit smoking

• The most common treatment modality among those that sought help was nicotine replacement and prescription medication

ENVIRONMENT & SYSTEMS (TOBACCO USE)

• 44% indicated that their providers did not ask about their

weight,

diet or nutrition

smoking or tobacco use

• 33 % indicated that their provider asked them about their physical activity level

ENVIRONMENT & SYSTEMS (HEALTH SYSTEM)

RECOMMENDATIONS (HEALTHY FOOD CHOICES)

• Build infrastructure to facilitate easy access to fresh fruits and vegetables for:

Farmers markets Local food production

• Build infrastructure to facilitate access to health food choices in small grocery stores

• Make fresh fruits & vegetables more available & affordable

• Future opportunities o Utilize the findings of the present study as a

benchmark to measure progress

• Create information hub of community resources to increase awareness of places for physical activity

• Provide affordable places for exercise

• Collaborate with health professionals , communities and organizations to encourage physical activity

RECOMMENDATIONS (PHYSICAL ACTIVITY)

Reduce tobacco use and exposure• Implement smoke free Multi-unit housing policies• Reinforce laws that provide • Provide education and implement policies that reduce

tobacco use across all age groups and socio-economic groups.

Patient – provider counseling• Implement clinical guidelines for

weight management diet or nutrition counseling tobacco use

RECOMMENDATIONS (CONTD.)

NEXT STEPS?

1. Suggestions on recommendations2. What is it that we want people to know?

Fact sheet Leadership team Brief online report

THANK YOU!

Documents

2010 Saint - Paul, MN Metro Adult Health Survey for Ramsey County